Volume 23, Issue 12 (3-2025)
JRUMS 2025, 23(12): 1076-1092 |
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Ethics code: IR.BASU.REC.1402.095
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Yalfani A, Sori F, Ahmadi M, Asgarpoor A. The Effect of Adding Pain Neuroscience Education to Motor Control Exercises in Water and Dry Environments on Plantar Pressure Distribution Symmetry in Women with Non-Specific Chronic Low Back Pain: A Clinical Trial. JRUMS 2025; 23 (12) :1076-1092
URL: http://journal.rums.ac.ir/article-1-7480-en.html
URL: http://journal.rums.ac.ir/article-1-7480-en.html
Abstract: (714 Views)
Background and Objectives: Motor control disorder in patients with chronic non-specific low back pain (NSCLBP) can change the plantar pressure distribution, increase the spine loading, and lead to the development of NSCLBP. The present study aimed to determine the effect of adding pain neuroscience education to motor control exercises in water and dry environments on plantar pressure distribution symmetry in women with NSCLBP.
Materials and Methods: This clinical trial was conducted in 2024 at Bu Ali Sina University, Hamadan. Sixty women with NSCLBP were conveniently selected and randomly assigned into experimental and control groups (n=30). The experimental group received motor control exercises in water and land environments along with neuroscience education for 4 weeks, and the control group did not receive any intervention. Pain intensity, kinesiophobia, and plantar pressure distribution were assessed in the pre-test and post-test stages. Multivariate analysis of covariance (MANCOVA) was used to analyze the data.
Results: Comparison of the results between the groups showed that there was a significant difference in pain reduction (p<0.001), kinesiophobia (p<0.001), and improvement in plantar pressure distribution symmetry in the experimental group compared to the control group (p<0.001).
Conclusion: Combination of neuroscience education and motor control exercises over a 4-week period significantly reduced pain intensity and kinesiophobia with a medium effect size and improved the plantar pressure distribution symmetry. Therefore, it is suggested that physiotherapists consider the mentioned exercises for the rehabilitation of patients with NSCLBP Keywords: Chronic non-specific low back pain, Plantar pressure distribution, Motor control, Pain neuroscience training, Hydrotherapy
Funding: This study did not have any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics committee of Bu-Ali Sina University approved the study (IR.BASU.REC.1402.095).
Authors’ contributions:
- Conceptualization: Ali Yalfani, Fatemeh Sori
- Methodology: Ali Yalfani, Fatemeh Sori
- Data collection: Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor
- Formal analysis: Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor
- Supervision: Ali Yalfani
- Project administration: Ali Yalfani
- Writing – original draft: Ali Yalfani
- Writing – review & editing: Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor
Materials and Methods: This clinical trial was conducted in 2024 at Bu Ali Sina University, Hamadan. Sixty women with NSCLBP were conveniently selected and randomly assigned into experimental and control groups (n=30). The experimental group received motor control exercises in water and land environments along with neuroscience education for 4 weeks, and the control group did not receive any intervention. Pain intensity, kinesiophobia, and plantar pressure distribution were assessed in the pre-test and post-test stages. Multivariate analysis of covariance (MANCOVA) was used to analyze the data.
Results: Comparison of the results between the groups showed that there was a significant difference in pain reduction (p<0.001), kinesiophobia (p<0.001), and improvement in plantar pressure distribution symmetry in the experimental group compared to the control group (p<0.001).
Conclusion: Combination of neuroscience education and motor control exercises over a 4-week period significantly reduced pain intensity and kinesiophobia with a medium effect size and improved the plantar pressure distribution symmetry. Therefore, it is suggested that physiotherapists consider the mentioned exercises for the rehabilitation of patients with NSCLBP Keywords: Chronic non-specific low back pain, Plantar pressure distribution, Motor control, Pain neuroscience training, Hydrotherapy
Funding: This study did not have any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics committee of Bu-Ali Sina University approved the study (IR.BASU.REC.1402.095).
Authors’ contributions:
- Conceptualization: Ali Yalfani, Fatemeh Sori
- Methodology: Ali Yalfani, Fatemeh Sori
- Data collection: Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor
- Formal analysis: Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor
- Supervision: Ali Yalfani
- Project administration: Ali Yalfani
- Writing – original draft: Ali Yalfani
- Writing – review & editing: Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor
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Citation: Sori F, Yalfani A, Ahmadi MR, Asgarpoor A. The Effect of Adding Pain Neuroscience Education to Motor Control Exercises in Water and Dry Environments on Plantar Pressure Distribution Symmetry in Women with Non-Specific Chronic Low Back Pain: A Clinical Trial. J Rafsanjan Univ Med Sci 2025; 23 (12): 1076-92. [Farsi]
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Keywords: Chronic non-specific low back pain, Plantar pressure distribution, Motor control, Pain neuroscience training, Hydrotherapy
Type of Study: Research |
Subject:
تربيت بدني
Received: 2024/08/15 | Accepted: 2025/02/11 | Published: 2025/03/20
Received: 2024/08/15 | Accepted: 2025/02/11 | Published: 2025/03/20
References
1. Turci AM, Nogueira CG, Nogueira Carrer HC, Chaves TC. Self-administered stretching exercises are as effective as motor control exercises for people with chronic non-specific low back pain: a randomised trial. JPh 2023; 69(2): 93–9.
2. Hirota R, Teramoto A, Murakami T, Yoshimoto M, Iesato N, Yamashita T. Effects and limitations of home-based motor-control exercise for chronic low back pain: A single center prospective study. Plos One 2023; 18(4): e0284741.
3. Gouteron A, Tabard-Fougère A, Moissenet F, Bourredjem A, Rose-Dulcina K, Genevay S, et al. Sensitivity and specificity of the flexion and extension relaxation ratios to identify altered paraspinal muscles’ flexion relaxation phenomenon in nonspecific chronic low back pain patients. J O E and K 2023; 68: 102740.
4. Joseph HL, Deepashini H, Omar B, Paungmali A, Amaramalar SN, Ohnmar H, et al. Reliability Study of Plantar Pressure Measurement Among Low Back Pain Patients Carrying Different Loads. J Sci Res 2014; 21(7): 1044–50.
5. Yalfani A, Khani MM, Ahmadi M, Asgarpoor A. The Effect of Core Stability Exercises Combined With Abdominal Hollowing on Postural Balance in Patients With Non-specific Chronic Low Back Pain: A Randomized Controlled Trial. Phys Treat J 2023; 13(3): 165–74.
6. Byström MG, Rasmussen-Barr E, Grooten WJ. Motor control exercises reduces pain and disability in chronic and recurrent low back pain: a meta-analysis. Spine 2013; 38(6): 350-8.
7. Yalfani A, M Mohamadkhani, MR Ahmadi AA. The Effect of Core Stability Exercises with Abdominal Hollowing on Plantar Pressure Distribution Symmetry in Females with Chronic Non-Specific Low Back Pain: An Experimental Study. CHJ 2023; 17(3): 81–92.
8. Anukoolkarn K, Vongsirinavarat M, Bovonsunthonchai S, Vachalathiti R. Plantar pressure distribution pattern during mid-stance phase of the gait in patients with chronic non-specific low back pain. J Med Assoc Thail 2015; 98(9): 896–901.
9. Hmida J, Tomschi F, Strauss AC, Hilberg T. Relationship between foot pressure and spinal parameters in healthy adults – A systematic review. JGP 2023; 103(2): 126–32.
10. Lee JH, Fell DW, Kim K. Plantar pressure distribution during walking: comparison of subjects with and without chronic low back pain. JoPhThS 2011; 23(6): 923-6.
11. Patricio, P., Roy, J.S., Macedo, L., Roy, M., Léonard, G., Hodges, P., et al. Repetitive transcranial magnetic stimulation alone and in combination with motor control exercise for the treatment of individuals with chronic non-specific low back pain (ExTraStim trial): study protocol for a randomised controlled trial. BMJ Open 2021; 11(3): e045504.
12. Ansari S, Elmieh A, Alipour A. The effect of aquatic exercise on functional disability, flexibility and function of trunk muscles in postmenopausal women with chronic non-specific low back pain: Randomized controlled trial. Sci & Amp Sport 2021; 36(3): e103–10.
13. Yalfani A, Raeisi Z, Koumasian Z. Effects of eight-week water versus mat pilates on female patients with chronic nonspecific low back pain: Double-blind randomized clinical trial. J Body w Mov Ther 2020; 24(4): 70–5.
14. Soheili S, Letafatkar A, Hosseinzadeh M. The effect of patient-led goal setting approach combined with pain neuroscience education or manual therapy in patients with chronic low back pain: protocol for a parallel-group randomized controlled trial. Trials 2023; 8; 24(1): 573.
15. Rabiei P, Sheikhi B, Letafatkar A. Comparing Pain Neuroscience Education Followed by Motor Control Exercises with Group-Based Exercises for Chronic Low Back Pain: A Randomized Controlled Trial. Pain Pract 2021; 21(3): 333–42.
16. Yalfani A, Asgarpoor A. The Effect of Cognitive Functional Therapy on Gait Kinetics in Women with Chronic Non-Specific Low Back Pain: A Clinical Trial Study. J Rafsanjan Univ Med Sci 2024; 23(6): 552–67.
17. O'Keeffe M, O'Sullivan P, Purtill H, Bargary N, O'Sullivan K. Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial (RCT). BJOSM 2020; 54(13): 782-9.
18. Hlaing SS, Puntumetakul R, Khine EE, Boucaut R. Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC MD 2021; 22: 1-3.
19. Bemani S, Dehkordi SN, Sarrafzadeh J, Talebian S, Salehi R, Zarei J. Efficacy of a multidimensional versus usual care physiotherapy on pain and electroencephalography (EEG) spectrum in chronic nonspecific low back pain: study protocol for a randomized controlled trial. Trials 2021; 22: 1-1.
20. Fujii R, Imai R, Tanaka S, Morioka S. Kinematic analysis of movement impaired by generalization of fear of movement-related pain in workers with low back pain. Plos One 2021; 17; 16(9): e0257231.
21. Chaharmahali L, Gandomi F, Yalfani A, Fazaeli A. The effect of self-reported knee instability on plantar pressure and postural sways in women with knee osteoarthritis. J Orthop Surg Res 2021; 16(1): 1–10.
22. Armstrong K, Gokal R, Chevalier A, Todorsky W, Lim M. Microcurrent Point Stimulation Applied to Lower Back Acupuncture Points for the Treatment of Nonspecific Neck Pain. J A C Med 2017; 23(4): 295–9.
23. Nazary S, Ahmad S, Letafatkar A, Brewer BW, Sharifnezhad A. Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial. BMC MD 2023; 1–13.
24. Yalfani A, Ahmadi M. Effect of neurofeedback training on psychological features and plantar pressure distribution symmetry in patients with patellofemoral pain: A ransdomized controlled trial. JBodywMovTher 2024; 40: 141-7.
25. Rahmati N, Ali Asghari Moghadam M, Reza Shairi M, Paknejad M, Rahmati Z, Ghassami M, et al. Psychometric properties of the Tampa Scale for Kinesiophobia amongst Iranian patients with chronic persistent pain. J Iran Inst Heal Sci 2019; 11(1): 1–14.
26. Yalfani A, Ahadi F, Ahmadi M. Effects of pain exacerbation on postural control in women with patellofemoral pain during single leg squat: a cross-sectional study. JoOrthSR 2024; 19(1): 462.
27. Yalfani A, Ahmadi AH, Ahmadi M, Asgarpoor A. Effect of foot orthoses on plantar pressure symmetry in taekwondo athletes with flexible flatfoot: A randomized controlled trial. JSOT 2024; 40(1): 50-7.
28. Yalfani A, Lotfi F, Ahmadi M, Asgarpoor A. The Effect of Sensorimotor Training on the Plantar Pressure Distribution Symmetry in Healthy Elderly: A Field Trial Study. Phys Treat Specif Phys Ther J 2022; 10(4): 249–60.
29. Mohammadi V, Letafatkar A, Sadeghi H, Jafarnezhadgero AA, Hilfiker R. The effect of motor control training on kinetics variables of patients with non-specific low back pain and movement control impairment: Prospective observational study. JBodywMovTher 2017; 21(4): 1009–16.
30. Ferreira ML, Ferreira PH, Latimer J, Herbert RD, Hodges PW, Jennings MD, et al. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: a randomized trial. Pain 2007; 131(1-2): 31-7.
31. Ibrahim AA, Akindele MO, Ganiyu SO, Bello B. Integrative Medicine Research Effects of motor control exercise and patient education program in the management of chronic low back pain among community-dwelling adults in rural Nigeria: a study protocol for a randomized clinical trial. Integr Med Res 2019; 8(2): 71–81.
32. Gorji SM, Mohammadi Nia Samakosh H, Watt P, Henrique Marchetti P, Oliveira R. Pain neuroscience education and motor control exercises versus core stability exercises on pain, disability, and balance in women with chronic low back pain. Intet J Enviro Public Health 2022; 19(5): 2694.
33. Maher CG, Latimer J, Hodges PW, Refshauge KM, Moseley GL, Herbert RD, et al. The effect of motor control exercise versus placebo in patients with chronic low back pain. BMC MD 2005; 6: 54.
34. Ahmadi M, Yalfani A, Gandomi FKR. The Effect of Twelve-Week Neurofeedback Training on Pain, Proprioception, Strength and Postural Balance in Men with Patellofemoral Pain Syndrome: A Double-Blind Randomized Control Trial. J Rehabil Sci Res 2020; 10(1): 1–13.
35. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Printed in the United States of America 1988; Bibliography: p.Includes index, ISBN 0-8058-0283-5, 1-551.
36. Wang H, Zheng J, Fan Z, Luo Z, Wu Y, Cheng X, et al. Impaired static postural control correlates to the contraction ability of trunk muscle in young adults with chronic non-specific low back pain: A cross-sectional study. G & P 2022; 92: 44-50.
37. Behennah J, Conway R, Fisher J, Osborne N, Steele J. The relationship between balance performance, lumbar extension strength, trunk extension endurance, and pain in participants with chronic low back pain, and those without. Clin Biomech 2018; 53(3): 22–30.
38. Ge L, Wang C, Zhou H, Yu Q, Li X. Effects of low back pain on balance performance in elderly people: a systematic review and meta-analysis. Eur Rev Aging Phys Act 2021; 18(1): 1–10.
39. Puntumetakul R, Chalermsan R, Hlaing SS, Tapanya W, Saiklang P, Boucaut R. The effect of core stabilization exercise on lumbar joint position sense in patients with subacute non-specific low back pain: a randomized controlled trial. J Phys Ther Sci 2018; 30(11): 1390–5.
40. Coulombe BJ, Games KE, Neil ER, Eberman LE. Core stability exercise versus general exercise for chronic low back pain. J Athl Train 2017; 52(1): 71–2.
41. de Oliveira FCL, Larivière C, Dallaire M, Mecheri H, Ngomo S, da Silva RA. Immediate Effect of Lumbosacral Orthosis and Abdominal Drawing-In Maneuver on Postural Control in Adults with Nonspecific Chronic Low Back Pain. J Manipulative Physiol Ther 2022; 45(6): 425–35.
42. Arendt EA. Core strengthening. Instr Course Lect 2007; 56: 379–84.
43. Lendraitienė E, Styraitė B, Šakalienė R, Misytė G, Bileviciute-Ljungar I. Effects of Pain Neuroscience Education and Physiotherapy on Chronic Low Back Pain, Fear of Movement and Functional Status: A Randomised Pilot Study. J Clin Med 2024; 13(7).
44. Yalfani A, Asgarpoor A. The effect of cognitive functional therapy on the plantar pressure distribution symmetry in patients with chronic non-specific low back pain: A randomized controlled trial. J BodywMovTher 2024; 40: 1454-9.
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